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A Prospective Study

Ronald J. Hené, MD; Peter Velthuis, MD; Albert van de Wiel, MD; Dick Klepper; Evert J. Dorhout Mees, MD; Louis Kater, MD

Arch Intern Med. 1986;146(4):745-749.

Abstract
• Granular deposits of IgA are known to occur in the walls of superficial vessels in apparently healthy skin of patients with primary IgA nephropathy, Henoch-Schönlein purpura, or alcoholic liver disease, but the specificity of the finding is still a matter of debate. We investigated the disease specificity of these deposits in the skin of patients with kidney and liver diseases. The sensitivity of the finding for the diagnosis of primary IgA was 75%, the specificity was 88%. The sensitivity for the diagnosis of alcoholic liver disease was 71%, but the specificity was only 60%. The specificity for the diagnosis of Henoch-Schönlein purpura, primary IgA nephropathy, or alcoholic disease (in a group of 1,030 patients with various diseases) was 94%. Immunoelectron-microscopic investigation showed the IgA deposits localized within the endothelial cell and in the subendothelial rim.

(Arch Intern Med 1986;146:745-749)

Author Affiliations
From the Departments of Nephrology (Drs Hené and Dorhout Mees), Dermatology (Dr Velthius), Immunopathology (Drs van de Wiel and Kater), and Electronmicroscopy (Mr Klepper), University Hospital, Utrecht, the Netherlands.

Footnotes
Accepted for publication July 2, 1985.

Reprint requests to Department of Nephrology and Hypertension, University Hospital, Catharijnesingel 101, 3511 GV Utrecht, the Netherlands (Dr Hené).

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